Provider Demographics
NPI:1588614572
Name:CUETO, JUAN C (MD)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:C
Last Name:CUETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4150 NW 7TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5535
Mailing Address - Country:US
Mailing Address - Phone:305-442-1159
Mailing Address - Fax:305-442-0658
Practice Address - Street 1:4150 NW 7TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5535
Practice Address - Country:US
Practice Address - Phone:305-442-1159
Practice Address - Fax:305-442-0658
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0060255207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055905900Medicaid
FL055905900Medicaid
FLF01852Medicare UPIN